Article
Resting energy expenditure measured versus calculated in obese burn patients: Does inclusion of body mass index improve estimates of metabolic requirements? – a pilot study
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Published: | September 3, 2014 |
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Background: An increasing number of overweight patients is recognized in burn centers.
Question: Finding the most suitable of four equations for REE for varying body mass indices (BMI) in burn population.
Methods: 39 burn patients from 26 to 65 years old were evaluated in the study. TBSA varied from 2%-17%. Mean BMI was 29.0 (16.5 to 42.7 kg/m2). REE was estimated by Ireton-Jones (IJ), Curreri, Mifflin St. Jeor, and Ireton-Jones/Curreri (IJ/C) combination (Curreri – IJ x 0.66 +(IJ)) and measured by indirect calorimetry. Scatter plots of BMI and the 4 equations versus REE measured via indirect calorimetry and general linear modeling to predict REE with BMI and each predictive equation were employed. Controls were matched pairs of non-burned 18 men and 18 women.
Results: Mean REE was 2029.2 Kcal and ranged from 1267 Kcal to 2750 Kcal. REE showed normal distribution. There were two trends without BMI co-variable: although not statistically significant, IJ/C formula predicted REE the closest in obese burn patients, the best formula predicting REE in non-obese burn patients was IJ. Regression of calculated REEs with BMI was statistically significant (P<0.001) in the burned and non-burned group. Approximately 74% of REE variation was explained by the model, BMI was positively associated with REE (P<0.0004). Interestingly, inclusion of TBSA did not affect REE prediction.
Conclusions: Although IJ and IJ/C formulas predicted measured REE best, the sample is too small for statistical significant analysis. Findings reflect high correlation of REE, BMI and the four used equations in this small sample.